Salmonellosis is one of the most important foodborne infections in the European Union
(EU), causing more than 90,000 human salmonellosis cases with an overall economic
burden of 3 billion Euro annually (EFSA, 2014). Salmonella enterica serovar Enteritidis
(S. Enteritidis or SE) and Salmonella enterica serovar Typhimurium (S. Typhimurium
or ST) are the most pathogenic serotypes, also the most frequently reported serovars
in humans in the EU. To fight against zoonotic diseases, including Salmonella, the
EU established an extended control programme (Regulation (EC) No 2160/2003) that was
launched in 2007. The cost-effectiveness of the control programme has not been examined
at EU-level and there are only a limited number of national assessments available
in the subject. The authors of the present paper conducted a retrospective cost-utility
analysis of the Hungarian Salmonella Control Programme (HSCP) for the years 2007–2017.
Costs and outcomes were considered from the state's perspective. Country-specific
cost of illness estimates and a quality-adjusted life year (QALY) -based burden estimate
have been developed for human salmonellosis cases. The programme's results were compared
to a reference arm where incidence, hospitalization and mortality rates were extrapolated
after 2007 by adjusting for the slight annual changes in population demographics,
as if no control measures had been introduced in Hungary. The incremental cost-effectiveness
ratio (ICER) was calculated and compared to the national health technology assessment
(HTA) threshold, defined as 3xGDP per capita (EMMI, 2017). Since the calculated ICER
value (27,150 EUR/QALY gain) was below the threshold (35,790 EUR/QALY gain), the HSCP
was found to be cost-effective for the investigated time period. The analysis can
serve as a model to carry out further analyses in relation to other pathogens or interventions
and help the priority setting and decision-making processes of food safety in Hungary.
Further discussion is needed on methodological questions, such as the perspective
of the analysis or the inclusion or exclusion of various cost types.
